Wiki PE vs E&M

[jpolinsky]

I have a question about a physical being billed to the patients Cigna insurance company. The remit states a physical is not covered under their plan. Patient calls the office and complains about the bill.
Looking at the office note, the physician addressed several other issues-OSA, GERD, gout, obesity, HTN, PVC, prediabetes. Medications were refilled and/or changed and an EKG was done. In addition, patient education regarding disease counseling.
Can I rebill the visit out as an E&M? Is there an ethical issue with that?
Thank you for any additional input on this.

 

[mitchellde]

If the patient was asymptomatic and these other conditions are just a part of the patients "baggage" that they bring along with them, and it states they are here for the preventive annual then you cannot bill with regular office visit level.

 

[jpolinsky]

Thank you! Appreciate the response.